Mike CzechowskyjFerris State University
Nursing Ethics Education and Support
Ethics
Rules of behaviors based on ideas about what is morally good and bad. (Merrium & Webster, 2014)
Health care professionals encounter ethical situations on a constant basis.
For the best patient outcomes nurses need to be able to identify these situations and react appropriately.
The gap
What is the current state of ethics in the continuing care setting?
How are nurses involved? What is the future state the
CNO would like to see?
The Proposed Plan
What is the root cause and the barriers related to a lack of recognizing ethical situations?
A fishbone diagram was used to visually identify the issues.
Unable to act on ethical concerns
Health System
Nursing StaffAdministration
Physicians
Resources
Money
Infrastructure
Education
How to get support
Baseline knowledge
Capacity to help
Ethicist
Knowledge of problem
Identify the need
Provide finances
Prioritize the project
Fishbone for Unrecognized Ethical Situations
The Proposed Plan The plan starts by working with key
stakeholders to develop a survey, education presentation and algorithm.
The survey will be given to nurses in the facility identified
The same nurses will then be taught using the education presentation.
They will also be taught the algorithm they can use when ethical situations are identified.
There will then be a post survey to validate that the nurses understand the new plan.
Change Theory Used
Influencer Model (Patterson, Grenny, Maxield, McMillan, &
Switzler, 2008)
Change the environmentHarness peer pressureFind strength in numbersDesigning rewards and demand
accountability
Leadership Theory Used
Authentic Leadership (Waite, Mckinney, Smith-Glasgow, &
Meloy, 2014).
Understands sense of one’s selfPerceived as open, optimistic, and resilient.Genuine
Evidence to Support This Plan
In the current environment the CNO has identified a lack of ethical awareness.
Lack of good ethical education in nursing school (Vynckier, Gastmans, Cannaerts, & Dierckx de Casterle, 2014).
No continuing education currently in the workplace at Spectrum Health Continuing Care.
Having an algorithm will help with decision making.
Better ethical identification would lead to less burnout and turnover (Blacking, 2011).
Implementation Support
Using QSEN competencies (QSEN Institute, 2014) Teamwork and CollaborationSafety
ANA Scope & Standards (American Nurses Association
2009)
CollaborationEthicsResource Utilization
Facility Identified
Spectrum Health Continuing Care Hospice Why this unit? Who will be educated?
Preceptor
Deb Cress, MSN, RN, NE-BC. CNO Why is she qualified to oversee this
project?Years of experienceAccess to resourcesAbility to break down barriers
Evaluation
Two different result evaluationsSurvey resultsNumber of ethics consults
Conclusion
This plan should set up Spectrum Health Continuing Care for…Better recognition of ethical situationsImproved support for the patientsAdded support for the nursing staffLess burnout and frustration
ReferencesAmerican Nurses Association. (2009). Nursing Administration: Scope and standards of practice. Silver
Spring, MD: Nursebooks.org.
Blacking, C. (2011). Empowering nurses to participate in ethical-decision making at the bedside. Journal of Continuing Education in Nursing, 42(1), 19-24. dio: 10.3928/00220124-20100601-03.
Merriam- Websters. (2014). Ethics. Retrieved from http://www.merriam-webster.com/dictionary/ethics
Patterson, K., Grenny, J., Maxield, D., McMillan, R., & Switzler, A. (2008). Influencer: The Power to Change Anything, New York, NY: McGraw-Hill.
QSEN institute, (2014). Graduate KSAS. Retrieved from http://qsen.org/competencies/graduate-ksas/
Vynckier, T., Gastmans, C., Cannaerts, N., & Dierckx de Casterle, B. (2014). Effectiveness of ethics education as perceived by nursing students: development and testing of a novel assessment instrument. Nursing Ethics. dio: 10.1177/0969733014538888.
Waite, R., Mckinney, N., Smith-Glasgow, M. E., & Meloy, F. A. (2014). The embodiment of authentic leadership. Journal of Professional Nursing, 30(4), 282-291. dio: 10.1016.j.profnurs.2013.11.004.